Read R W, Rao N A
Doheny Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Ocul Immunol Inflamm. 2000 Dec;8(4):227-34. doi: 10.1076/ocii.8.4.227.6457.
The diagnosis of Vogt-Koyanagi-Harada syndrome is hampered by its variable manifestations and the lack of unique ancillary and laboratory findings. In this study, the diagnostic criteria established in 1978 by the American Uveitis Society (AUS) are retrospectively analyzed via their application to a population of 71 consecutive patients, using only those features present at the initial evaluation. All patients were previously diagnosed with Vogt-Koyanagi-Harada syndrome based on the clinical features and course of the disease combined with fluorescein angiography with or without ultrasonography in selected cases. Mean age of all patients was 36.7 years +/- 15.1 years. Fifty (70%) were female and 45 (65%) were Hispanic. Patients presenting acutely, subacutely, and in the chronic stages met the AUS criteria for Vogt-Koyanagi-Harada syndrome in 56%, 48%, and 58% of cases, respectively. Allowance for variation in features, incomplete cases, and modification of the disease by treatment might increase the sensitivity of the criteria. While diagnostic criteria in general are useful for establishing the likelihood that a patient has a disease, the current AUS criteria for the diagnosis of Vogt-Koyanagi-Harada syndrome do not seem adequate.
Vogt-小柳-原田综合征的诊断因其临床表现多样以及缺乏独特的辅助检查和实验室检查结果而受到阻碍。在本研究中，回顾性分析了美国葡萄膜炎协会（AUS）于1978年制定的诊断标准，该标准仅应用于71例连续患者，且仅采用初次评估时出现的特征。所有患者此前均根据疾病的临床特征和病程，结合荧光素血管造影（部分病例还包括超声检查）诊断为Vogt-小柳-原田综合征。所有患者的平均年龄为36.7岁±15.1岁。50例（70%）为女性，45例（65%）为西班牙裔。急性、亚急性和慢性期患者符合AUS的Vogt-小柳-原田综合征诊断标准的病例分别为56%、48%和58%。考虑到特征的变化、病例不完整以及治疗对疾病的改变，可能会提高该标准的敏感性。虽然一般的诊断标准有助于确定患者患某种疾病的可能性，但目前AUS的Vogt-小柳-原田综合征诊断标准似乎并不充分。
